The Los Angeles HIV Research & Community Colloquia Series Hosted by Los Angeles County HIV Prevention & Planning Committee

Presentation:

The Social Context of Risk Among Heterosexually-Active Homeless Men in Skid Row, Los Angeles

Presenters:

Suzanne Wenzel, PhD, Professor, USC School of Social Work

Harmony Rhoades, PhD, Research Assistant Professor, USC School of Social Work

Date/Time:

November 3, 2011

12:00pm – 1:00pm

(NO REGISTRATION NEEDED, OPEN MEETING)

Location:

St. Anne’s Maternity Home – Foundation Conference Room

155 N. Occidental Blvd.

Los Angeles, CA 90026

Abstract:

Homeless persons are at high risk of HIV/AIDS, with estimated rates at 3x higher than those in the general population. HIV/AIDS is increasingly a disease of impoverished persons, and homeless persons engage in higher rates of risky behaviors due to subsistence living and reduced access to services. Men’s heterosexual behavior also plays a key role in the HIV epidemic, as more than 80% of women with HIV/AIDS are infected through sex with men. To examine the social context of risk among heterosexually-active homeless men, this study utilized probability sampling to achieve a representative sample of this population in Los Angeles’ Skid Row area. Men were screened and sampled from 13 meal lines: 5 breakfasts, 4 lunches, and 4 dinners at 5 different organizations. Structured personal interviews were conducted between July and October 2010, with a final sample size of 305 heterosexually-active homeless men. In addition to information about individual characteristics and risk behavior, data were collected on men’s egocentric personal networks. Respondents provided the first names of 20 individuals (social network alters) that they knew, who knew them, and that they had contact with (face-to-face, by phone, mail, internet) in the past six months and provided information on alter type, risk behavior, and network structure.

This presentation will discuss findings regarding two major areas of risk behavior in this population: Substance use and concurrent sexual partnering. In the past six months, the three most prevalent substances utilized by men in this study were marijuana (56%), crack (40%), and alcohol to intoxication (38%). The primary correlates of substance use included mental health status, with PTSD associated with crack use; as well as riskier social networks, with more drug-using alters associated with marijuana use, and normative social ties providing protection against crack use. Nearly 40% of the men in this study reported concurrency with one of their four most recent sex partners. Sexual partner concurrency was more likely among heterosexually-active men who were HIV+, and those who experienced symptoms of PTSD or used hard drugs. The perception that social network alters engage in risky sex was also associated with increased odds of concurrent sexual partnering. The multiple vulnerabilities faced by homeless men put this population at particular risk for the negative health effects of substance use, and high rates of sexual concurrency pose significant HIV/STI transmission risk among heterosexually active homeless men. These findings suggest that addressing PTSD and the social context of homeless men’s lives are crucial aspects for effective risk reduction in this population.

About the presenters:

Dr. Suzanne Wenzel

Suzanne Wenzel received her PhD in community psychology from The University of Texas at Austin. She completed a postdoctoral fellowship sponsored by NIMH at the Rutgers/Princeton Program in Mental Health Research and UCLA. Following a 15 year career as a behavioral scientist at the RAND Corporation, she accepted a full professorship at the USC School of Social Work in 2009 and also holds a joint appointment in the Department of Psychology. Through multiple NIH grants, she has conducted research involving homeless and other vulnerable populations for the past 15 years.

Dr. Harmony Rhoades

Harmony Rhoades received her PhD in Sociology from UCLA, and holds an MS degree in Epidemiology from the UCLA School of Public Health. She was a predoctoral trainee in the UCLA ‘Service Systems for Persons Living with HIV/AIDS’ Research Training Program, and completed a postdoctoral fellowship with Dr. Suzanne Wenzel on the NICHD study ‘Heterosexual HIV Risk Behavior in Homeless Men.’ Dr. Rhoades is currently a Research Assistant Professor in the USC School of Social work, where she continues to conduct research involving HIV risk behavior among homeless populations.